Tixel for Crepey/Loose Neck Skin
Crepey neck skin is one of the most common and stubborn age-related concerns. It’s caused by collagen loss, elastin degradation, and thinning of the dermis. The result is paper-like texture, horizontal lines, and fine laxity that creams can’t fix.
At Dr Hans Clinics, we approach crepey neck skin with regenerative synergy rather than isolated treatments. One of our most reliable combinations is Tixel® followed by Sunekos®, spaced two weeks apart.
Understanding the Problem: Why Neck Skin Ages Faster
The neck’s dermis is thinner, has fewer sebaceous glands, and is constantly exposed to UV, friction, and motion. Collagen I and III decline, elastin fibres fragment, and the extracellular matrix loses hydration. Unlike the face, the neck has limited pilosebaceous units and microcirculation, meaning healing and turnover are slower.
So when patients complain that their neck looks older than their face, they’re right.
Why Tixel Works
Tixel uses Thermo-Mechanical Action (TMA) to deliver controlled thermal energy into the dermis. The 400°C titanium pyramids briefly press against the skin without penetrating it. The rapid transfer of heat creates micro-coagulation columns that trigger fibroblast activation and neocollagenesis.
Unlike lasers, Tixel doesn’t rely on light absorption, making it safe across all skin types and colours. The epidermis remains intact, which means fast recovery and very low risk of pigmentation.
Tixel induces tightening and collagen remodelling, reducing fine lines and crepiness without the downtime associated with CO₂ or RF microneedling.
Why Sunekos Complements Tixel
Sunekos is an injectable blend of amino acids (glycine, proline, lysine, hydroxyproline) and non-crosslinked hyaluronic acid. It stimulates fibroblast biosynthesis of collagen and elastin, specifically in the extracellular matrix, where Tixel has initiated wound healing.
Tixel opens the dermis; Sunekos provides the building blocks. Together, they accelerate and sustain regeneration.
Case Study: Quantificare 3D Imaging Results
Patient: Female, early 40s
Concern: Crepey texture and mild laxity under the chin and upper neck
Protocol:
- One session of Tixel (medium setting: 10/400, full contact coverage)
- Followed by Sunekos 200 two weeks later
Imaging: Quantificare 3D assessment
Before: 03/10/2025
After: 23/10/2025
Even after just one session, the 3D scan shows visible improvement in skin texture, light reflection, and firmness. The lower chin contour appears smoother, with less creasing and a healthier skin tone.
Quantificare’s surface mapping confirms the skin density and textural improvement after initiating collagen remodelling with Tixel and reinforcing matrix integrity with Sunekos.
How the Combination Works
| Step | Treatment | Mechanism | Effect |
|---|---|---|---|
|
1 |
Tixel |
Thermo-mechanical microcoagulation |
Controlled heat damage triggers collagen and elastin renewal |
|
2 |
Sunekos (2 weeks later) |
Amino acid + HA injection |
Provides fibroblasts with substrate for matrix synthesis |
|
3 |
Combined Result |
Sequential biostimulation |
Improved elasticity, hydration, and dermal density |
The neck area responds particularly well to staged stimulation because it cannot tolerate aggressive resurfacing. Tixel and Sunekos respect that biology; gentle but powerful.
Clinical Timeline
Day 0: Tixel session. Mild erythema for 24 hours. No downtime.
Week 2: Sunekos injection session. Mild swelling for 1 day.
Week 3-4: Skin starts to feel firmer and smoother. Fine lines soften.
Week 6: Visible lift and brightness, confirmed on 3D imaging.
Why This Approach Is Evidence-Based
- Tixel: Clinical studies demonstrate increased collagen I and III and dermal thickness after fractional thermo-mechanical resurfacing, with lower risk of PIH compared to fractional lasers.
- Sunekos: Peer-reviewed data shows improved skin elasticity and hydration through stimulation of fibroblast ECM activity.
- Combination: Sequential regenerative stimulation aligns with wound-healing physiology; injury followed by biochemical support yields better long-term outcomes.
Together, they create what neither can achieve alone: collagen induction, hydration, and elasticity restoration without adding artificial volume.
Who Benefits Most
- Early to moderate crepey neck skin
- Mild submental laxity
- Photoaged or dehydrated skin
- Patients intolerant to laser or RF treatments
- Fitzpatrick III-VI seeking pigment-safe rejuvenation
Safety and Downtime
Both treatments have extremely low downtime. Tixel may cause mild warmth and redness for a day; Sunekos results in temporary swelling or pinpoints. No bleeding, crusting, or significant discomfort.
Honest Expectations
One combined treatment can show visible difference, as seen in this case, but results compound with repeated sessions.
For optimal and lasting improvement, a course of three Tixel and three Sunekos sessions, each spaced two weeks apart, is ideal. Maintenance once or twice a year sustains collagen turnover.
Evidence & Expectations Box
Mechanism: Sequential dermal biostimulation (TMA + amino acid-HA matrix activation)
Results: Improved texture, firmness, hydration, and light reflectivity
Downtime: 1-2 days mild redness or swelling
Sessions: Typically 3-4 treatments for lasting change
Safety: All skin types, minimal discomfort
Expectation: Natural regeneration and visible softening, not artificial tightness
Final Word
This isn’t “tightening” in the marketing sense but it’s true regeneration with firmness and improved structure of the skin layers
Tixel wakes the fibroblasts; Sunekos feeds them.
Together, they rebuild what time and UV have thinned, restoring real structural quality to the neck’s most delicate skin.
For patients who want smoother, firmer skin without downtime or pigment risk, this is one of the most effective evidence-based combinations available today.
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